JEFFREY CHONAWORAH ADISAM NPI 1851831911

NPI Information

NPI: 1851831911
Provider Name: JEFFREY CHONAWORAH ADISAM
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Individual
Address:
1087 E INDEPENDENCE ST
306
GIDDINGS, TX
ZIP 78942
Phone: (720) 277-7404
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Jeffrey Chonaworah Adisam is a community based residential treatment facility, intellectual and/or developmental disabilities in Giddings, TX. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Jeffrey Chonaworah Adisam NPI is 1851831911. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1087 E INDEPENDENCE ST
306
GIDDINGS, TX
ZIP 78942-434
Phone: (720) 277-7404

The enumeration date for this NPI number is 3/8/2017 and was last updated on 3/8/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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